Blood Collection Agency Messaging to Donors and the Public in Canada and Australia during the Early Days of COVID-19

COVID-19 has posed unprecedented challenges to health systems around the world, including blood collection agencies (BCAs). Many countries, such as Canada and Australia, that rely on non-remunerated voluntary donors saw an initial drop in donors in the early days of the pandemic followed by a return to sufficient levels of the blood supply. BCA messaging plays a key role in communicating the needs of the blood operator, promoting and encouraging donation, educating, and connecting with the public and donors. This paper is an interpretive discourse analysis of BCA messaging in Canada and Australia from March 1-July 31, 2020 to understand how BCAs constructed donation to encourage donation during this period and what this can tell us about public trust and blood operators. Drawing on multiple sources of online content and print media, our analysis identified four dominant messages during the study period: 1) blood donation is safe;2) blood donation is designated an essential activity;3) blood is needed;and 4) blood donation is a response to the pandemic. In Canada and Australia, our analysis suggests that: 1) in a time of uncertainty, donors and some publics trusted the BCA to be an organization with expertise to ensure that donation is safe, essential, and able to meet patient needs;and 2) BCAs demonstrated their trustworthiness by aligning their messaging with public health and scientific experts. For BCAs, our analysis supports donor communications that are transparent and responsive to public concerns and the local context to support public trust. Beyond BCAs, health organizations and leaders cannot underestimate the importance of building and maintaining public trust as countries continue to struggle with containment of the virus and encourage vaccine uptake. © Haw, Thorpe and Holloway.

Age and Hospitalization Risk in People With Type 1 Diabetes and COVID-19: Data From the T1D Exchange Surveillance Study.

CONTEXT: COVID-19 morbidity and mortality are increased in type 1 diabetes (T1D), but few data focus on age-based outcomes. OBJECTIVE: This work aimed to quantify the risk for COVID-19-related hospitalization and adverse outcomes by age in people with T1D. METHODS: For this observational, multisite, cross-sectional study of patients with T1D and laboratory-confirmed COVID-19 from 56 clinical sites in the United States, data were collected from April 2020 to March 2021. The distribution of patient factors and outcomes across age groups (0-18, 19-40, and > 40 years) was examined. Descriptive statistics were used to describe the study population, and multivariate logistic regression models were used to analyze the relationship between age, adverse outcomes, and hospitalization. The main outcome measure was hospitalization for COVID-19. RESULTS: A total of 767 patients were analyzed. Fifty-four percent (n = 415) were aged 0 to 18 years, 32% (n = 247) were aged 19 to 40 years, and 14% (n = 105) were older than 40 years. A total of 170 patients were hospitalized, and 5 patients died. Compared to the 0- to 18-years age group, those older than 40 years had an adjusted odds ratio of 4.2 (95% CI, 2.28-7.83) for hospitalization after adjustment for sex, glycated hemoglobin A1c, race, insurance type, and comorbidities. CONCLUSION: Age older than 40 years is a risk factor for patients with T1D and COVID-19, with children and younger adults experiencing milder disease and better prognosis. This indicates a need for age-tailored treatments, immunization, and clinical management of individuals affected by T1D.

Preparedness cycle to address transitions in diabetes care during the COVID-19 pandemic and future outbreaks.

The COVID-19 pandemic is considered a mass casualty incident of the most severe nature leading to unearthed uncertainties around management, prevention, and care. As of July 2020, more than twelve million people have tested positive for COVID-19 globally and more than 500 000 people have died. Patients with diabetes are among the most severely affected during this pandemic. Healthcare systems have made emergent changes to adapt to this public health crisis, including changes in diabetes care. Adaptations in diabetes care in the hospital (ie, changes in treatment protocols according to clinical status, diabetes technology implementation) and outpatient setting (telemedicine, mail delivery, patient education, risk stratification, monitoring) have been improvised to address this challenge. We describe how to respond to the current public health crisis focused on diabetes care in the USA. We present strategies to address and evaluate transitions in diabetes care occurring in the immediate short-term (ie, response and mitigation), as well as phases to adapt and enhance diabetes care during the months and years to come while also preparing for future pandemics (ie, recovery, surveillance, and preparedness). Implementing multidimensional frameworks may help identify gaps in care, alleviate initial demands, mitigate potential harms, and improve implementation strategies and outcomes in the future.